| NPI | 1275012247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 0016944) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36002939A) | |
| Enumeration Date | 2018-08-10 |
| Last Update Date | 2025-09-02 |